Career Summary

Biography

Amanda Wilson has a strong research background having worked in both clinical and public health research for many years. She has worked in a variety of health care environments including general practice, the community and tertiary teaching hospitals. While completing a Bachelor of Arts (Hons) in English, Amanda began working part-time in clinical trials on asthma. This led to full-time employment in clinical respiratory research, involving asthma, COPD and sleep disorders. Her position involved trial design, implementation, data collection, analysis, writing and presentation of results. Amanda was a reviewer with the Cochrane Airways Group and developed and co-authored the first comprehensive report on evidence-based asthma management (Australian Asthma Management Plan 2000).

She published a number of well cited papers in international and Australian peer-review journals, presented at international conferences, produced several industry reports and co-authored of a chapter in "Understanding Asthma: A Management Companion" edited by Dr Christine Jenkins. In 2000, Amanda joined the Newcastle Institute of Public Health (NIPH) as a Research Officer with a research focus on health services research. She produced several papers and reports including the NHMRC “Using Socioeconomic Evidence in Clinical Practice Guidelines Handbook” and the Clinical Service Framework for Respiratory Disease for NSW Department of Health.

As part of her role, she tutored Medical Students at the University of Newcastle. While at NIPH, Amanda co-founded the Media Doctor website (mediadoctor.org.au) with Professor David Henry and has worked on the site as a reviewer and data manager since its inception in 2002. In 2005, Amanda and Professor David Henry were awarded the Australian Museum Eureka Prize for ‘Critical Thinking’ for their work on Media Doctor. During this period (2001 - 2005) Amanda also completed a Master of Creative Arts in writing. She was awarded a full Postgraduate Research Scholarship and began a PhD in the Discipline of Medicine and Public Health, Faculty of Health. Using data from the Media Doctor website, Amanda examined how the media deals with various aspects of health and the impact of the website on the quality of this reporting. Her thesis is one of only a handful worldwide in the area of health reporting and, probably the only one which uses an evidence-based appraisal of the quality of content.

In 2010, her thesis “Assessing the Quality of Health News Stories in the Australian Media Using the Media Doctor Website” was examined with no changes required and PhD awarded. Five papers have been published based on her PhD work, all in high quality peer-review journals, including PLoS Medicine, PLoS One and Medical Journal of Australia. Amanda is currently working with A/Prof Kyp Kypri, as a Research Academic using her research and web skills to perform online studies examining methodology and social desirability bias in the area of alcohol. She also continues her work in the area of health literacy and media content with the Media Doctor website.

Research ExpertiseMy research background involves expertise in both the humanities and health. I have explored the quality of health media in Australia and impact of this information of health literacy. My ongoing research with mediadoctor.org.au will examine ways of improving the quality of medical and scientific information that is transmitted through the media to the general public and the potential of raising health literacy. I am also exploring the use of web based platforms in health research including the most effective way to employ this medium for participant recruitment, online study data collection and database management. This research involves interventions examining social desirability bias and study methodology in the context of changes in social behaviour such as alcohol use.

BACKGROUND: A key component of many asthma management guidelines is the recommendation for patient education and regular medical review. A number of controlled trials have been co... [more]

BACKGROUND: A key component of many asthma management guidelines is the recommendation for patient education and regular medical review. A number of controlled trials have been conducted to measure the effectiveness of asthma education programmes. These programmes improve patient knowledge, but their impact on health outcomes is less well established. This review was conducted to examine the strength of evidence supporting Step 6 of the Australian Asthma Management Plan: "Educate and Review Regularly"; to test whether health outcomes are influenced by education and self-management programmes. OBJECTIVES: The objective of this review was to assess the effects of asthma self-management programmes, when coupled with regular health practitioner review, on health outcomes in adults with asthma. SEARCH STRATEGY: We searched the Cochrane Airways Group trials register and reference lists of articles. SELECTION CRITERIA: Randomised trials of self-management education in adults over 16 years of age with asthma. DATA COLLECTION AND ANALYSIS: Trial quality was assessed and data were extracted independently by two reviewers. Study authors were contacted for confirmation. MAIN RESULTS: Twenty-five trials were included. Self-management education was compared with usual care in 22 studies. Self-management education reduced hospitalisations (odds ratio 0.57, 95% confidence interval 0.38 to 0.88); emergency room visits (odds ratio 0.71, 95% confidence interval (0.57 to 0.90); unscheduled visits to the doctor (odds ratio 0.57, 95% confidence interval 0.40 to 0.82); days off work or school (odds ratio 0.55, 95% confidence interval 0.38 to 0. 79); and nocturnal asthma (odds ratio 0.53, 95% confidence interval 0.39 to 0.72). Measures of lung function were little changed. Self-management programmes that involved a written action plan showed a greater reduction in hospitalisation than those that did not (odds ratio 0.35, 95% confidence interval 0.18 to 0.68). People who managed their asthma by self-adjustment of their medications using an individualised written plan had better lung function than those whose medications were adjusted by a doctor. REVIEWER'S CONCLUSIONS: Training in asthma self-management which involves self-monitoring by either peak expiratory flow or symptoms, coupled with regular medical review and a written action plan appears to improve health outcomes for adults with asthma. Training programmes which enable people to adjust their medication using a written action plan appear to be more effective than other forms of asthma self-management.

BACKGROUND: A key component of many asthma management guidelines is the recommendation for patient education and regular medical review. A number of controlled trials have been co... [more]

BACKGROUND: A key component of many asthma management guidelines is the recommendation for patient education and regular medical review. A number of controlled trials have been conducted to measure the effectiveness of asthma education programmes. These programmes improve patient knowledge, but their impact on health outcomes is less well established. At its simplest level, education is limited to the transfer of information about asthma, its causes and its treatment. This review focused on the effects of limited asthma education. OBJECTIVES: The objective of this review was to assess the effects of limited (i.e. information only) asthma education on health outcomes in adults with asthma. SEARCH STRATEGY: We searched the Cochrane Airways Group trials register and reference lists of articles. SELECTION CRITERIA: Randomised and controlled trials of individual asthma education involving information transfer only in adults over 16 years of age. DATA COLLECTION AND ANALYSIS: Trial quality was assessed and data were extracted independently by two reviewers. Study authors were contacted for missing information. MAIN RESULTS: Eleven trials were included. They were of variable quality. Limited asthma education did not reduce hospitalisation for asthma (weighted mean difference -0.03 average hospitalisations per person per year, 95% confidence interval -0.09 to 0.03). There was no effect on doctor visits, lung function and medication use. The effects on asthma symptoms were variable. There was no reduction in days lost from normal activity, but perceived asthma symptoms did improve after limited asthma education (odds ratio 0.40, 95% confidence interval 0.18 to 0.86). In one study, limited asthma education was associated with reduced emergency department visits (weighted mean difference -2.76 average visits per person per year, 95% confidence interval -4.34 to 1.18). REVIEWER'S CONCLUSIONS: Use of limited asthma education as it has been practiced does not appear to improve health outcomes in adults with asthma. However the use of information in the emergency department may be effective, but this needs to be confirmed.

BACKGROUND: Theophylline and long acting beta2-agonists are bronchodilators used for the management of persistent asthma symptoms, especially nocturnal asthma. They represent diff... [more]

BACKGROUND: Theophylline and long acting beta2-agonists are bronchodilators used for the management of persistent asthma symptoms, especially nocturnal asthma. They represent different classes of drug with differing side-effect profiles. OBJECTIVES: To assess the comparative efficacy, safety and side-effects of long-acting beta-agonists and theophylline in the maintenance treatment of asthma. SEARCH STRATEGY: Randomised, controlled trials (RCTs) were identified using the Cochrane Airways Group register. The register was searched using the following terms: asthma and theophylline and long acting beta-agonist or formoterol or foradile or eformoterol or salmeterol or bambuterol or bitolterol. Titles and abstracts were then screened to identify potentially relevant studies. The bibliography of each RCT was searched for additional RCTs. Authors of identified RCTs were contacted for other relevant published and unpublished studies. SELECTION CRITERIA: All included studies were RCTs involving adults and children with clinical evidence of asthma. These studies must have compared oral sustained release and/or dose adjusted theophylline with an inhaled long-acting beta-agonist. DATA COLLECTION AND ANALYSIS: Potentially relevant trials, identified by screening titles and/or abstracts, were obtained. Two reviewers independently assessed full text versions of these trials to decided whether the trial should be included in the review, and assessed its methodological quality. Where there was disagreement between reviewers, this was resolved by consensus, or reference to a third party. Data were extracted by two independent reviewers. Inter-rater reliability was assessed by simple agreement. Study authors were contacted to clarify randomisation methods, provide missing data, verify the data extracted and identify unpublished studies. Relevant pharmaceutical manufacturers were also contacted. MAIN RESULTS: Six trials met the inclusion criteria. Five used salmeterol and one, biltoterol. They were of varying quality. There was a trend for salmeterol to improve FEV1 more than theophylline in three studies and salmeterol use was associated with more symptom free nights. Bitolterol, used in only one study, was reported to be less effective than theophylline. Subjects taking salmeterol experienced fewer adverse events than those using theophylline (Relative Risk 0.38; 95%Confidence Intervals 0.25, 0.57). Significant reductions were reported for central nervous system adverse events (Relative Risk 0.51; 95%Confidence Intervals 0.30, 0.88) and gastrointestinal adverse events (Relative Risk 0.32; 95%Confidence Intervals 0.17, 0.59). REVIEWER'S CONCLUSIONS: Salmeterol may be more effective than theophylline in reducing asthma symptoms including night waking and improving lung function. More adverse events occurred in subjects using theophylline when compared to salmeterol.

National asthma management guidelines have improved awareness of the rising morbidity and mortality from asthma but have not been widely implemented at a local level. This paper d... [more]

National asthma management guidelines have improved awareness of the rising morbidity and mortality from asthma but have not been widely implemented at a local level. This paper describes the use of continuous quality improvement techniques to facilitate the implementation of asthma management guidelines within a tertiary hospital setting. A baseline audit demonstrated satisfactory emergency assessment and treatment, but identified poor compliance with the patient education aspects of the asthma management plan. An evaluation of the literature demonstrated that programs combining asthma education and management were effective when directed towards adults with a recent severe asthma exacerbation. An asthma education and management service was developed to address these deficits. A repeat audit was conducted which identified improvements in asthma control and management skills for patients attending the education program, together with reductions in asthma re-admission rates for patients referred to the service. Ongoing quality assessments will target nonattenders to the service and the maintenance of asthma skills. An area Asthma Health Outcomes Council was formed to address the issues of asthma management throughout the area health service.

Research Supervision

Current Supervision

Time to Rethink Resilience: New Directions in Theory, Assessment and Treatment InterventionNursing, Faculty of Health and MedicineCo-Supervisor

2014

Promoting active ageing in older people with mental disorders in Thai Primary Care Units: the development and psychometric testing of an assessment toolNursing, Faculty of Health and MedicineCo-Supervisor